When is the last time you have used recreational or illicit drugs (cocaine, LSD, heroin, barbiturates, narcotics, opiates, amphetamines, hallucinogens, tranquilizers, PCP, steroids for non-medical reasons, or etc.)?

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14.

When was the last time you have had a tattoo or body piercing?

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15.

How many current sexual partners do you have?

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16.

Do you or one of your partners in the last 5 years have HIV, Hepatitis B or C, or has been an IV (intravenous) drug user?

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17.

Do you have both ovaries?

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18.

What was your age at the onset of menses?

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19.

Are your menstrual periods regular (when not on the pill)?

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20.

How long is your monthly cycle (first day of one period to first day of the next)?

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21.

Have you ever been told by a medical doctor that you were infertile and/or conceived with fertility treatments?

Have you ever been seen by psychiatrist, psychologist, social worker, counselor, or any other medical health professional for any reason?

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If yes, when, for how long, for what reason.

29.

Are you adopted?

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30.

Considering only your full-blood relatives, and considering only your grandparents, parents, maternal and paternal aunts and uncles, siblings, self and children, how many people have Alcohol and Drug issues/diseases?

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31.

Are your currently breastfeeding?

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32.

Are there known genetic problems in your family?

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If yes, please explain.

33.

How did you hear about the egg donation program at REACH?

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Please explain

34.

Our organization uses a secure server for some email communication with you. The server is www.donorapplication.com. Email will come to you from no-reply@donorapplication.com. The domain of donorapplication.com needs to be acceptable to your spam filters to ensure email communication. (Google: "how to add an email address to safe list in (Outlook, Google, Yahoo, etc.)"

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35.

What is your email address for communication with you regarding your pre-screen application?